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Ingrown Toenail Surgery

Ingrown Toenail Surgery

The treatment process:

If you develop painful ingrown toenails. Here at Foot & Ankle Experts, we give patients 4 surgical options.

 

Surgical Procedure 1: Partially removing the nail

For more severe ingrown toenail (redness, pain, puss), Dr Kim can trim or remove the ingrown portion of the nail after numbing your toe by injecting local anesthetic in a painless way.

 

Surgical Procedure 2: Partial nail avulsion with phenol acid (PA) or Trichloroacetic acid (TCA).

Phenol acid cauterisation offers painless, quick recovery (1-2 days), cosmetically satisfying removal of partial toenail with a success rate of 80%.
Whereas, TCA cauterisation offers painless, moderate recovery rate (5-10days), cosmetically satisfying removal of partial toenail with a success rate of 98%.

 

Surgical Procedure 3: Modified Winograd procedure with Noel’s technique

In order to remove hypergranulated tissues, 4-5 stitches adhere to the excision site, perfect for complicated recurrent ingrown toenail with skin lesion.
This is a safe procedure even for paediatric patients to be performed under local anesthesia. We use absorbable stitches preventing further postoperative stitch removals. Cosmetically very satisfying with the least amount of discomfort involved. The dressing will be changed every three days with MLS post-op laser therapy to boost your painless fast healing recovery.

 

Surgical Procedure 4: Removing the nail and surrounding tissue permanently (Super U Procedure)

If you have the infection and toenail problem repeatedly after the above intervention, Dr Kim may suggest removing a portion of the nail along with the underlying tissue. Please note the procedure is very extensive and it is very unlikely to be the first or final choice of operations as it involves long recovery days. This procedure is only fit for patients with no systemic health risk or comorbidities and onychomycosis.

References:
Dermatol Surg. 2008 Jan;34(1):79-83. doi.10.1111/j.1524-4725.2007.34012.x.
Actas Dermosifiliogr. 2017 Jun;108(5):438-444. doi: 10.1016/j.ad.2017.01.010. Epub 2017 Mar 8.pub 2007 Dec 5.

Post care treatment:

Once surgery is complete, we ask you to wear open-toe shoes for at least one week, but ideally two, for the best results.

3 days after your surgery, we will then have a follow up appointment (Post-Surgery Care) for redressing and a short session with the PBM laser. We have found the best results from patients who follow the combination of these 3 things.
After your first Post-Surgery Care appointment, we do recommend returning 3 days later for another round of Post-Surgery Care, but it is optional.

If you are unable to come back, we do recommend you change the dressing every 3 days, for 2 weeks after your surgery.

2 weeks after your surgery, it is recommended you come back for a review with Dr Kim, if she has not seen you since the surgery.